Amiodarone is a widely used anti-arrhythmic drug. Several case reports describe optic neuropathy which has been linked to its use. This case series discusses the diagnosis of amiodarone-associated optic neuropathy (AAON) and its potential impact on cardiac therapy. The authors present distinguishing features of AAON versus non-arteritic ischaemic optic neuropathy (NAION): bilaterality, mode of onset, degree of optic nerve dysfunction, structure of uninvolved disc in unilateral cases and systemic toxic effects. The authors conducted a retrospective chart review and identified 13 patients with optic neuropathy and amiodarone therapy between 1995 and 2015 in one hospital setting. The clinical features for these 13 patients are summarised by the authors. Overall, there is a lack of evidence for the existence of AAON nor reliable criteria of differentiation between AAON and NAION, however, the use of amiodarone should be explored if patients present with optic neuropathy. Further research is required to explore the possible pathophysiology of optic neuropathies. 

Amiodarone-associated optic neuropathy – a clinical criteria-based diagnosis?
Fasler K, Traber GL, Jaggi GP, Landau K.
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Claire Howard

Salford Royal NHS Foundation Trust, Salford, UK.

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